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Organization

LAKES REGIONAL MENTAL HEALTH MENTAL RETARDATION CENTER

Active
Other names
Lakes Regional Community Center
Organization subpart
No

Provider details

NPI number
Authorized official
JACKIE WAYNE VAUGHN (CHIEF EXECUTIVE OFFICER)
(972) 388-2000
Entity
Organization

Contact information

Practice address
400 AIRPORT RD, TERRELL, TX 75160-4302
(972) 524-4159
(972) 563-5321
Mailing address
PO BOX 747, TERRELL, TX 75160-0014
(972) 524-4159
(972) 524-1002

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10001427
AMERIGROUP GRP
TX
05
121988304
TX
05
121988305
TX
01
126278
VO GRP
TX
01
126813
SUPERIOR GRP
TX
01
CK7759
PALMETTO GRP
TX
01
LAKES-001
COMPCARE GRP
TX
Enumeration date
12/04/2006
Last updated
04/15/2026
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